BILL NUMBER: AB 1545	CHAPTERED  10/10/99

	CHAPTER   914
	FILED WITH SECRETARY OF STATE   OCTOBER 10, 1999
	APPROVED BY GOVERNOR   OCTOBER 9, 1999
	PASSED THE ASSEMBLY   SEPTEMBER 9, 1999
	PASSED THE SENATE   SEPTEMBER 8, 1999
	AMENDED IN SENATE   SEPTEMBER 3, 1999
	AMENDED IN SENATE   AUGUST 16, 1999
	AMENDED IN SENATE   JULY 6, 1999
	AMENDED IN ASSEMBLY   MAY 17, 1999
	AMENDED IN ASSEMBLY   APRIL 15, 1999

INTRODUCED BY   Assembly Member Correa
   (Coauthor:  Assembly Member Honda)

                        FEBRUARY 26, 1999

   An act to amend Sections 2725.1, 4061, 4076, 4170, and 4175 of the
Business and Professions Code, relating to health practitioners.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1545, Correa.  Health practitioners.
   Under existing law, a nurse practitioner may not sign for delivery
of a complimentary sample of a dangerous drug or dangerous device;
may not direct a pharmacist to dispense a trade name or generic drug;
use a dispensing device; or hand drugs or dangerous devices to
patients in his or her office or place of practice, as specified.
   This bill would authorize a nurse practitioner or, in some
instances, a physician assistant, to perform the above services, and
would make corresponding changes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Section 2725.1 of the Business and Professions Code is
amended to read:
   2725.1.  Notwithstanding any other provision of law, a registered
nurse may dispense drugs or devices upon an order by a licensed
physician and surgeon when the nurse is functioning within a licensed
clinic as defined in paragraphs (1) and (2) of subdivision (a) of
Section 1204 of, or within a clinic as defined in subdivision (b) or
(c) of Section 1206, of the Health and Safety Code.
   No clinic shall employ a registered nurse to perform dispensing
duties exclusively.  No registered nurse shall dispense drugs in a
pharmacy, keep a pharmacy, open shop, or drugstore for the retailing
of drugs or poisons.  No registered nurse shall compound drugs.
Dispensing of drugs by a registered nurse, except a nurse
practitioner who functions pursuant to a standardized procedure
described in Section 2836.1, or protocol, shall not include
substances included in the California Uniform Controlled Substances
Act (Division 10 (commencing with Section 11000) of the Health and
Safety Code). Nothing in this section shall exempt a clinic from the
provisions of Article 3.5 (commencing with Section 4063) of Chapter
9.
  SEC. 2.  Section 4061 of the Business and Professions Code is
amended to read:
   4061.  No manufacturer's sales representative shall distribute any
dangerous drug or dangerous device as a complimentary sample without
the written request of a physician, dentist, podiatrist, or
veterinarian. However, a nurse practitioner who functions pursuant to
a standardized procedure described in Section 2836.1, or protocol,
or physician assistant who functions pursuant to Section 3502.1 may
sign for the delivery or receipt of complimentary samples of a
dangerous drug or dangerous device that has been requested in writing
by his or her supervising physician.  Each written request shall
contain the names and addresses of the supplier and the requester,
the name and quantity of the specific dangerous drug desired, the
name of the nurse practitioner or physician assistant, if applicable,
receiving the samples pursuant to this section, the date of receipt,
and the name and quantity of the dangerous drugs or dangerous
devices provided.  These records shall be preserved by the supplier
with the records required by Section 4059.
  SEC. 3.  Section 4076 of the Business and Professions Code is
amended to read:
   4076.  (a) A pharmacist shall not dispense any prescription except
in a container that meets the requirements of state and federal law
and is correctly labeled with all of the following:
   (1) Except where the prescriber or nurse practitioner who
functions pursuant to a standardized procedure described in Section
2836.1, or protocol, or physician assistant who functions pursuant to
Section 3502.1 orders otherwise, either the manufacturer's trade
name of the drug or the generic name and the name of the
manufacturer.  Commonly used abbreviations may be used.  Preparations
containing two or more active ingredients may be identified by the
manufacturer's trade name or the commonly used name or the principal
active ingredients.
   (2) The directions for the use of the drug.
   (3) The name of the patient or patients.
   (4) The name of the prescriber and, if applicable, the nurse
practitioner who functions pursuant to a standardized procedure
described in Section 2836.1, or protocol, or physician assistant who
functions pursuant to Section 3502.1.
   (5) The date of issue.
   (6) The name and address of the pharmacy, and prescription number
or other means of identifying the prescription.
   (7) The strength of the drug or drugs dispensed.
   (8) The quantity of the drug or drugs dispensed.
   (9) The expiration date of the effectiveness of the drug
dispensed.
   (10) The condition for which the drug was prescribed if requested
by the patient and the condition is indicated on the prescription.
   (b) If a pharmacist dispenses a prescribed drug by means of a unit
dose medication system, as defined by administrative regulation, for
a patient in a skilled nursing, intermediate care, or other health
care facility, the requirements of this section will be satisfied if
the unit dose medication system contains the aforementioned
information or the information is otherwise readily available at the
time of drug administration.
   (c) If a pharmacist dispenses a dangerous drug or device in a
facility licensed pursuant to Section 1250 of the Health and Safety
Code, it is not necessary to include on individual unit dose
containers for a specific patient, the name of the nurse practitioner
who functions pursuant to a standardized procedure described in
Section 2836.1, or protocol, or physician assistant who functions
pursuant to Section 3502.1.
  SEC. 4.  Section 4170 of the Business and Professions Code is
amended to read:
   4170.  (a) No prescriber shall dispense drugs or dangerous devices
to patients in his or her office or place of practice unless all of
the following conditions are met:
   (1) The dangerous drugs or dangerous devices are dispensed to the
prescriber's own patient and the drugs or dangerous devices are not
furnished by a nurse or physician attendant.
   (2) The dangerous drugs or dangerous devices are necessary in the
treatment of the condition for which the prescriber is attending the
patient.
   (3) The prescriber does not keep a pharmacy, open shop, or
drugstore, advertised or otherwise, for the retailing of dangerous
drugs, dangerous devices, or poisons.
   (4) The prescriber fulfills all of the labeling requirements
imposed upon pharmacists by Section 4076, all of the recordkeeping
requirements of this chapter, and all of the packaging requirements
of good pharmaceutical practice, including the use of childproof
containers.
   (5) The prescriber does not use a dispensing device unless he or
she personally owns the device and the contents of the device, and
personally dispenses the dangerous drugs or dangerous devices to the
patient packaged, labeled, and recorded in accordance with paragraph
(4).
   (6) The prescriber, prior to dispensing, offers to give a written
prescription to the patient that the patient may elect to have filled
by the prescriber or by any pharmacy.
   (7) The prescriber provides the patient with written disclosure
that the patient has a choice between obtaining the prescription from
the dispensing prescriber or obtaining the prescription at a
pharmacy of the patient's choice.
   (8) A nurse practitioner who functions pursuant to a standardized
procedure described in Section 2836.1, or protocol, or a physician
assistant who functions pursuant to Section 3502.1, may hand to a
patient of the supervising physician and surgeon a properly labeled
prescription drug prepackaged by a physician and surgeon, a
manufacturer as defined in this chapter, or a pharmacist.
   (b) The Medical Board of California, the State Board of Optometry,
the Board of Dental Examiners of California, the Osteopathic Medical
Board of California, the Board of Registered Nursing, and the
Physician Assistant Committee shall have authority with the
California State Board of Pharmacy to ensure compliance with this
section, and those boards are specifically charged with the
enforcement of this chapter with respect to their respective
licensees.
   (c) "Prescriber," as used in this section, means a person, who
holds a physician's and surgeon's certificate, a license to practice
optometry, a license to practice dentistry, or a certificate to
practice podiatry, and who is duly registered as such by the Medical
Board of California, the State Board of Optometry, the Board of
Dental Examiners of California, or the Board of Osteopathic Examiners
of this state.
  SEC. 5.  Section 4175 of the Business and Professions Code is
amended to read:
   4175.  (a) The California State Board of Pharmacy shall promptly
forward to the appropriate licensing entity, including the Medical
Board of California, the Board of Dental Examiners of California, the
State Board of Optometry, the Osteopathic Medical Board of
California, the Board of Registered Nursing, or the Physician
Assistant Committee, all complaints received related to dangerous
drugs or dangerous devices dispensed by a prescriber, nurse
practitioner, or physician assistant pursuant to Section 4170.
   (b) All complaints involving serious bodily injury due to
dangerous drugs or dangerous devices dispensed by prescribers, nurse
practitioners, or physician assistants pursuant to Section 4170 shall
be handled by the Medical Board of California, the Board of Dental
Examiners of California, the State Board of Optometry, the
Osteopathic Medical Board of California, the Board of Registered
Nursing, or the Physician Assistant Committee as a case of greatest
potential harm to a patient.
